Antibodies to non-functional p2x7 receptor

ABSTRACT

The present invention provides antibodies that specifically bind to P2X 7  receptors and distinguish between function and non-functional P2X 7  receptors, pharmaceutical compositions and kits containing the antibodies, and methods of using the antibodies for the detection, diagnosis and treatment of disease conditions.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.10/622,313, filed Jul. 17, 2003, which is a continuation-in-part ofPCT/AU02/00061 filed Jan. 17, 2002 published in English and designatingthe United States, which claims priority under 35 USC 119 from each ofAustralian provisional application no. PR2579 filed Jan. 17, 2001,Australian provisional application no. PRS890 filed on Jun. 22, 2001,Australian provisional application no. PRS891 filed on Jun. 22, 2001,Australian provisional application no. PR7430, filed Sep. 3, 2001, andAustralian provisional application no. PR7431 filed Sep. 3, 2001. Thepresent application is also a continuation of U.S. application Ser. No.10/622,313, filed Jul. 17, 2003, which is a continuation-in-part ofPCT/AU02/01204, filed Sep. 3, 2002 published in English and designatingthe United States, which claims priority under 35 USC 119 from each ofPCT/AU02/0061 filed Jan. 17, 2002, Australian provisional applicationno. PR7430, filed Sep. 3, 2001 and Australian provisional applicationno. PR7431 filed Sep. 3, 2001. All of the priority applications areincorporated by reference in their entirety for all purposes.

TECHNICAL FIELD

This invention concerns diagnosis and treatment of diseases, includingcancers. The types of diseases with which this invention is concernedinclude cancers derived from epithelial cells and malignant lymphoma.The invention also concerns other conditions, such as preneoplasticstates, irritable bowel syndrome and viral and other infections. It isquite possible that the invention is also applicable to other diseasesand conditions.

BACKGROUND

Adenosine triphosphate (ATP) can activate ligand-gated purinergicreceptors known as P2X receptors. Receptor subtypes P2X₁ to P2X₇ havebeen identified. It is known that different P2X receptor subtypes arepresent in many cells, including epithelial cells and leukocytes,including lymphocytes, thymocytes, macrophages and dendritic cells.

P2X receptors are permeable to calcium ions as well as some othercations, such as potassium and sodium. An influx of calcium ions into acell via a P2X receptor can be associated with cell death.

It is believed that the P2X₇ subtype is involved in apoptosis, orprogrammed cell death, in many cell types. In the presence of ATP, theP2X₇ receptor expressed on the surface of a cell is capable, within asecond, of opening calcium channels through the cell membrane. Continuedexposure to ATP can lead to the formation of large pores, within a fewseconds to tens of seconds, that enable the cell to be flooded withexcess calcium, inducing apoptosis.

The amino acid sequences of the human and rat P2X₇ receptors are known,for example, from U.S. Pat. No. 6,133,434 (Buell et al). Refer also toSEQ ID NO:1.

Exposure to ATP does not generally result in apoptosis in the case ofepithelial cancer cells, for example. It has been found that such cellsexpress P2X₇ receptors that are unable to form pores. These are regardedas non-functional receptors.

In human cancer cell lines, such as prostate PC3 and breast MCF7, aswell as in animal cell lines including rodent hybridomas, the P2X₇receptor is found on the cell surface in a non-functional conformation.

The B-cells of patients with malignant lymphoma express non-functionalP2X₇ receptors. Lymphoma develops from malignant clones that escapecytolytic destruction. This process leads to the progressiveaccumulation of malignant B-lymphocytes and thus lymphadenopathy and/orsplenomegaly.

SUMMARY OF THE INVENTION

In a first aspect, this invention provides a probe for detection of adisease or condition, the probe being adapted to distinguish betweenfunctional P2X₇ receptors and non-functional P2X₇ receptors. Preferably,the probe distinguishes between functional and non-functional P2X₇receptors by detecting change in relation to binding of adenosinetriphosphate (ATP) to the receptors or by detecting change in binding ofone or more proteins necessary for pore formation in P2X₇ receptors. Inan alternate embodiment, the probe detects one or more parts of the P2X₇receptor exposed in the absence of bound ATP. Such receptor part mayinclude a P2X₇ monomer.

The invention also provides a method for detecting a disease orcondition, the method including the steps of using the probe of theinvention to distinguish between functional P2X₇ receptors andnon-functional P2X₇ receptors, providing a receptor expression profile,and comparing the receptor expression profile with that of a normalprofile. The change may be detected, for example, as indicated above inconnection with the probe itself.

The probe may be natural or artificial. Preferably, the probe is anantibody, which may be polyclonal, monoclonal, recombinant, a humanisedantibody, a human antibody or an appropriate fragment thereof. Theantibody is preferably directed against an epitope located in anextracellular domain adjacent to a site for binding ATP. In the case ofhuman P2X₇ receptors, the probe is preferably adapted to distinguishbetween functional receptors having a sequence in which proline at aminoacid 210 is in the trans conformation and non-functional receptorshaving a sequence in which the proline at amino acid 210 is in the cisconformation that acts to impart a significant alteration in the localprotein structure.

Probes also include peptide and other compounds that have been screenedfor suitable binding specificity. Combinatorial libraries can beproduced for many types of compounds that can be synthesized in astep-by-step fashion. Such compounds include polypeptides, beta-turnmimetics, polysaccharides, phospholipids, hormones, prostaglandins,steroids, aromatic compounds, heterocyclic compounds, benzodiazepines,oligomeric N-substituted glycines and oligocarbamates. Largecombinatorial libraries of the compounds can be constructed by theencoded synthetic libraries (ESL) method described in Affymax, WO95/12608, Affymax, WO 93/06121, Columbia University, WO 94/08051,Pharmacopeia, WO 95/35503 and Scripps, WO 95/30642 (each of which isincorporated by reference for all purposes). Peptide libraries can alsobe generated by phage display methods. See, e.g., Dower, U.S. Pat. No.5,432,018.

The probe may be prepared using any suitable technique, as will bereadily apparent to one skilled in the art.

It is within the scope of the invention that the probe may distinguishbetween functional and non-functional receptors through detection ofother conformational changes occurring at a site for binding ATP. Forexample, the change detected may be in an amino acid other than theproline referred to above. An example of such an amino acid is Pro199which, when in the cis conformation, significantly alters the localprotein structure. As another example, the change detected may be insome other respect.

The probe may also be adapted to detect other regions of the P2X₇receptor unchanged by functional state. The conformation of themonomeric subunits lacking bound ATP may be detectable using the probe,as the epitope chosen may specifically detect the shape of a region ofthe surface of the receptor accessible only when ATP is not bound. Theprobe may detect change in binding of one or more proteins, such asaccessory or other proteins, necessary for pore formation. Non-limitingexamples of such proteins are laminin, integrin, beta-actin,alpha-actinin and supervillin.

In the present invention, a P2X₇ subtype-specific antibody can be usedto specifically detect or bind to non-functional P2X₇ receptorsexpressed in or on cells forming part of preneoplastic tissue, veryearly neoplastic tissue, advanced neoplastic tissue and on anyneoplastic cell expressing non-functional P2X₇ receptors. Thus, the P2X₇receptor is detected or bound only when in the close-gated ornon-functional conformation, even though it may be normally expressed inthe cell membranes and may otherwise be partially able to function as achannel.

Further, the conformation of the monomeric subunits lacking bound ATP isalso detectable with the antibody, because the epitope chosenspecifically detects the shape of a region of the surface accessibleonly when ATP is not bound.

In the present invention, the non-functional P2X₇ receptors can bedetected or bound by using an antibody directed against an epitope thatundergoes a conformational change from the structure present infunctional receptors. It has been found that the amino acid sequence ofthe non-functional receptors can be identical to the amino acid sequenceof functional receptors, so that the cause of the conformational changein the receptors relates to the interaction of the receptors with ATP.As set out above, the ATP molecules act as receptor agonists, so thatwhen ATP is bound to the receptors, they are able to open a channelthrough the cell membrane for the inflow of calcium ions.Non-functionality is therefore caused by a lack of appropriate bindingof the ATP agonists to the receptors, for reasons that may include adeficit in the local availability of ATP through production deficit orincrease in the rate of degradation. If ATP binding to the receptors isdisrupted, the receptor conformation is altered. This can be detected byusing an antibody specially designed to bind to the region of theprotein affected by the binding of the ATP.

In the case of human P2X₇ receptors, the specific sequence involved inthe conformational change may include Pro210, which undergoes a changein conformation from the trans form to the cis form in the absence ofbound ATP. Thus, in the case of human receptors, an appropriate epitopesequence against which an antibody must be raised may include Pro210,and may extend either side of this residue, to an appropriate extentnecessary to induce an antibody response. By way of non-limitingexample, this may include a segment extending from Gly200 to Thr215 orGly200 to Cys216. Further, a homologous segment (i.e., cognate segment)from other mammals, such as rat, may be used where this cross-reactswith human tissue. Allelic variants of the sequence shown in SEQ ID NO:1can also be used. As an example, the same segment Gly200 to Cys216 inrat may be used, although there are two amino acid substitutions in therat sequence compared with the human sequence (refer U.S. Pat. No.6,133,434, for example). Therefore, the segment used to generateantibodies is preferably a polypeptide comprising a segment including orconsisting of Gly200 to Thr 215 or Gly200 to Cys216. Preferably, thesegment includes no more than 30 contiguous amino acids from a P2X₇receptor, and more preferably consists of Gly200 to Thr215 or Gly200 toCys216.

In the case of non-human receptors, the specific sequence may beascertained by suitable experiment.

The detection of non-functional P2X₇ receptors according to theinvention may show a distribution pattern in which functional receptors(and hence normal cells) may remain essentially unlabelled. However,non-functional conformations of P2X₇ receptors may be detected,initially in the nuclei and cytoplasm of cells, at a very early stage inpreneoplasia. For example, in the case of epithelial cell cancer, usingthe method of the invention it may be possible to detect preneoplasiaseveral years prior to the normal pathological appearance of cancer asdetected by haematoxylin and eosin (“H & E”) stained slides of biopsiedtissues. Thus, cancers such as prostate, skin and breast may be detectedfar earlier than is currently the case, with the advantages ofintroduction of early therapy.

The full scope of the diseases and conditions which may be detected bythe probe and method of the invention has not yet been ascertained.However, it is believed that these include epithelial cell cancers, suchas prostate, breast, skin, lung, cervix, uterus, stomach, oesophagus,bladder, colon and vaginal cancers, as well as blood cancers includingmalignant lymphoma, irritable bowel syndrome and infection by virusessuch as HIV or other pathological organisms, such as Mycobacteriumtuberculosis. Infection may cause non-functional receptors to beexpressed either directly through inhibition of co-factors required forfunctionality, or through the up-regulation of co-factors acting toinhibit P2X₇ function on epithelial or other cells, so rendering theinfected cell less amenable to destruction by apoptosis.

Unless otherwise indicated, the term “disease or condition” as usedherein is intended to include all those specific diseases and conditionsset out in the preceding paragraph.

In the specific case of irritable bowel syndromes (“IBS”), it has nowbeen found that, in patients with this condition, the gut mucosa, thatnormally expresses P2X₇ receptors in the widely distributed lymphocytespresent in the stroma beneath the epithelium, becomes up-regulated. Inaffected patients, this increased expression can be observed fromduodenum to rectal mucosa. The increased expression may be found inisolated regions, or to be generally increased over the entire length ofthe intestinal tract in more extreme cases.

In the least affected cases, total P2X₇ receptors are up-regulated, butthese are all functional and they do not penetrate into the epithelium.In more severe cases, total P2X₇ receptor expression is even higher, andthe most affected areas of the gut exhibit receptors that arenon-functional. These may be localised to caecal mucosa, for example,and may penetrate into the epithelium. The most severe cases are thosein which total P2X₇ receptor expression is further increased and most ofthe receptors are non-functional with increased epithelial cellpenetration.

As already discussed, non-functionality of P2X₇ receptors is caused bylack of appropriate binding of the ATP agonist to the receptors. Thereasons for this may include a deficit in the local availability of ATPthrough production deficit or increase in rate of degradation throughecto-ATPase enzymatic degradation of ATP. If ATP binding to thereceptors is disrupted, the receptor conformation is altered as alreadydiscussed, and this can be detected using the probe of the invention.However, the detection of total P2X₇ receptor distribution is bestachieved using an epitope to other regions of the extracellular domainof the P2X₇ receptor that is not affected by ATP binding. The probe maybe capable of detecting regions of the P2X₇ receptor unchanged byfunctional state, by detecting an epitope common to both functional andnon-functional conformations, such as Val65-Lys81.

It is within the scope of this invention to use one or two P2X₇subtype-specific antibodies to specifically distinguish between totalP2X₇ distribution and the proportion of receptors that arenon-functional and expressed in gut mucosa. Thus the two antibodies usedtogether can detect both total receptor count and those receptorchannels present only in a close-gated or non-functional conformation.The first antibody is adapted to detect total P2X₇ receptor expression.The probe comprising or attached to the antibody of the invention canprovide the second antibody for detection of IBS, not onlydistinguishing between functional and non-functional P2X₇ receptors, butalso allowing for detection of other regions in which the receptor isunchanged by functional state. The antibodies may be used separately ortogether. Preferably, they are used in combination.

The detection of all P2X₇ receptors, separately from non-functional P2X₇receptors, determines the severity of the condition. Expression ofnon-functional P2X₇ receptors in the gastrointestinal mucosa occurs in apattern in which normal cells remain essentially unlabelled. Thereafter,the non-functional conformation of P2X₇ is first detected in the stromaunderneath the epithelium ranging from isolated patches in mild cases ofthe syndrome to extensive expression throughout the length of thegastrointestinal tract with isolated patches of infiltration ofnon-functional receptors into the epithelium.

The invention also provides a method of diagnosing irritable bowelsyndrome, comprising detecting the P2X₇ expression profile of cellsand/or tissue and comparing the profile with a predetermined expressionprofile of normal cells and/or tissue. Preferably, the detection of theP2X₇ expression profile includes use of one or more antibodies. Further,it is preferred that such antibody or antibodies are different from theprobe of the invention in that they do not detect change in relation tobinding of ATP to the P2X₇ receptors. The preparation of such antibodieswill be readily apparent to one skilled in the art.

The invention also includes use of one or more antibodies to diagnoseirritable bowel syndrome.

Therapeutic treatment for this condition is discussed below, inconnection with the third aspect of this invention.

The diagnostic can be used in standard microscopy employing standardimmunohistochemical techniques. The diagnostic may also be used in vivo.

Diagnosis using the probe and method of the invention may be carried outusing in situ imaging techniques to detect distribution in body tissues.In addition, standard microscopy, confocal microscopy and fluorescenceactivated cell sorting may be used. Normal immunohistochemicaltechniques for testing lymph, prostate, breast, skin, lung, uterus,bladder, cervix, stomach, oesophagus and similar biopsies, also fineneedle aspirates of breast and other tissue and cell smears such asthose taken for the detection of cervical cancer, may be used.

For in vivo diagnosis, it is preferred that the probe is a humanantibody or domain, manufactured with no animal components. The antibodyis preferably labelled with a short-lifetime radiolabel, detectable bymeans of scanning technology such as positron emission tomography (PETscanner). Such imaging can detect the aggregation of labelled antibodyanywhere in the body, thus signalling the presence of non-functionalreceptors, associated with the presence of any tumour. Ideally, such atest should be conducted only after detection of primary cancer and forthe purpose of checking for secondary cancer, or after a general screenby means of a blood test (refer below) has detected the likelihood ofthe presence of one of more tumours.

The probe and method of the invention may be employed to provide a bloodtest for detecting non-functional P2X₇ receptors and hence cancer orpre-cancerous conditions. By way of example, the probe in the form of afluorescent labelled antibody (monoclonal or polyclonal) can be used inflow cytometry against blood cell fractions of the patient in order todetect binding to non-functional receptors on various gated leukocytes,including T lymphocytes, B lymphocytes or macrophages.

In another form of blood test, the probe preferably takes the form of alabelled antibody attached to a matrix provided in a kit, enablingdetection by the presence of a colour reaction to the binding of thefixed antibody to positive white blood cells. Such a kit may be suitablefor use by medical practitioners.

In a similar blood test, the antibody probe of the invention may be usedas a diagnostic tool for screening patients who may not have cancer butin whom the normal cell killing pathways are inhibited through lack offunction in P2X₇ on one or more leukocytes. Such patients may expressnon-functional receptors on macrophages, indicating inhibition of theability of those macrophages to kill infected cells, such as thoseinfected by organisms like Mycobacterium tuberculosis, or otherinfectious agents including malaria and HIV. Such organismspreferentially proliferate in patients for whom the normal cell killingpathways are inhibited through lack of function in P2X₇ on one or moreleukocytes.

Other techniques may be used with the probe and method of the invention.

This invention provides an antibody for treating a disease or condition,the antibody being adapted to distinguish between functional P2X₇receptors and non-functional P2X₇ receptors and being adapted to bindonly to non-functional receptors. Preferably, the antibody distinguishesbetween the functional and non-functional receptors by detecting changein relation to binding of adenosine triphosphate (ATP) to the receptors,or by detecting change in binding of one or more proteins necessary forpore formation in P2X₇ receptors and being adapted to bind only tonon-functional receptors. In another embodiment, the antibodydistinguishes between the functional and non-functional receptors bydetecting parts of the receptor exposed in the absence of bound ATP.

The antibody for treating diseases and conditions may be the same as theantibody which may be used as the probe for diagnosing diseases andconditions. Such an antibody could be used to treat skin cancerstopically, for example. For systemic treatment of cancer, the antibodyor its active fragments should be human or a human domain, in order tominimise undesirable immune response side effects.

The antibody of the invention may be used to treat diseases orconditions in mammals, including humans. Examples of the diseases orconditions have been set out above in connection with the probe of theinvention.

The invention also provides an epitope capable of causing the generationof the antibody of the second aspect of the invention. The epitopepreferably includes Pro210 and encompasses the segment Gly200 to Cys216(in the P2X₇ sequence of the human receptor). The epitope shouldpreferably have attached to the C-terminal end a Cys residue (Cys216)that is cross-linked to diphtheria toxin via the chemical cross-linkermaleimidocaproyl-N-hydroxysuccinimide (MCS), so that the conformationadopted by the attached epitope peptide occupies a stable cis prolineconfiguration.

This specific peptide conformation is intended to be presented to humansor animals with one or more diseases or conditions, especiallyepithelial cell cancers, such as prostate, breast, skin, lung, cervix,uterus, stomach, oesophagus, bladder, colon and vaginal cancers, as wellas malignant lymphoma, irritable bowel syndrome and infection by virusessuch as HIV or other pathological organisms, such as Mycobacteriumtuberculosis. The patient will preferably mount an immune response tothe applied conjugated epitope and so generate antibodies recognisingthe non-functional P2X₇ receptors present on the surface of the affectedcells, thus binding to them and alerting the appropriate immune cell todestroy the complexed cells. Other cells primed for cell death may alsobe affected.

It is to be understood that the sequence referred to above is notlimiting on the scope of the invention, which includes alternatesequences and carriers and cross-linkers that similarly produce aspecific immune response, preferably against only non-functional P2X₇receptors, preferably ignoring all functional receptors expressed oncell surfaces, and so avoiding side effects.

The invention, in this second aspect, also provides for the use of theantibody of the invention as a therapeutic vehicle for treatment of adisease or condition in a patient to regulate programmed cell death bytargeting aberrant or non-functional P2X₇ receptors expressed on thesurface of cells, while leaving all cells expressing normal (functional)receptors untouched. The invention also covers the use of the epitope ofthe invention to cause the generation of the antibody, as above.

The invention also provides a pharmaceutical composition for treatmentor prevention of a disease or condition in a patient, the compositionincluding a pharmaceutically effective amount of an antibody, or anepitope to cause the generation of such an amount, capable of regulatingprogrammed cell death of cells having expressed on their surfaceaberrant or non-functional P2X₇ receptors.

The pharmaceutically effective amount of the antibody or epitope willvary according to the patient and the nature of the disease orcondition. These variables can be ascertained by one skilled in the art.

The pharmaceutical composition of the invention may be administered inconjunction with a pharmaceutically acceptable carrier, which may be anyof those known in the art or devised hereafter and suitable for theintended use. As well as carriers, the pharmaceutical compositions ofthe invention may include other ingredients, including dyes,preservatives, buffers and antioxidants, for example.

The pharmaceutical composition of the invention may take any desiredform and may be administered, for example, in the form of an ointment,cream, solution, suspension, powder, tablet, capsule, suppository orpessary.

The pharmaceutical composition of the invention may be administered inany suitable way, which may include oral, parenteral, intravenous,intramuscular, subcutaneous or topical administration.

The invention also provides a method of treating or preventing a diseaseor condition in a patient, the method including administering to thepatient a pharmaceutical composition according to the invention.

The invention also provides the use of the pharmaceutical composition ofthe invention, in the treatment or prevention of a disease or condition,in a patient.

It will be apparent to one skilled in the art that the pattern of use ofthe pharmaceutical composition of the invention may need to be alteredfor optimum effect. It may be necessary to take into account the natureof the disease or condition as well as its severity.

The third aspect of the invention focuses on the expression of ATPases(enzymes) that control the supply of ATP to P2X₇ receptors, for examplein the B-cells of a patient having malignant lymphoma. Channel openingof P2X₇ receptors on leukocytes is terminated through the rapidhydrolysis of ATP agonist by ecto-ATPases andecto-ATPdiphosphohydrolases (ecto-ATPDases). These enzymes regulatenumerous physiological processes that are dependent on ATP. Substratespecificity of ATPase and ATPDase activity on lymphocytes indicates thepresence on the lymphocytes of more than one type on the cell surface,including CD39. Proliferation of one or more of these ATPases orATPDases could limit the supply of ATP needed to control P2X₇ poreformation and the subsequent programmed cell death needed to regulateB-cell numbers.

Similarly, it is believed that, in the case of IBS, proliferation ofATPases may contribute to lack of appropriate binding of the agonist ATPto the P2X₇ receptors.

Accordingly, in this third aspect, the invention provides a preparationfor treatment or prevention of a disease or condition in a patient, thepreparation including one or more substances adapted to regulate theexpression of ATPases that control the supply of ATP to P2X₇ receptorsin the patient's cells or tissues. The invention also provides a methodof treating or preventing a disease or condition in a patient, themethod including the step of administering to the patient a preparationincluding one or more substances adapted to regulate the expression ofATPases that control the supply of ATP to P2X₇ receptors in the cells ortissue of the patient.

Examples of such ATPases may be CD39 or CD73.

Such a substance may take the form of an ATP analogue, preferablynon-hydrolysable, and specific for P2X₇, or another substance thatinhibits the action of local ATPases depleting the availability of ATPfor the P2X₇ binding site. The preparation may be in the form of a humanantibody directed specifically against non-functional P2X₇ receptors.

A substance such as an ATP analogue may bind to the P2X₇ and hold it inopen pore configuration, thus forcing the pore to assume a functionalstate, in which it is able to take up both large and small cationpermeants. In this way the use of such a synthetic agonist may act torestore receptor function, at the same time as controlling the growthadvantage that P2X₇ provides cells in its role as a calcium channel.

An ATP analogue may take the form of AMPPNP or AMPPCP or AMPNPP orAMPCPP preferably with stabilizing moieties to improve the affinity ofthe analogue for the ATP binding sites on the P2X₇ receptor. Suchstabilizing moieties could include the benzoyl, benzoyl group attachedto the ribose moiety on ATP. Additional stabilizing groups may be usefulsuch as modifications to the adenine made in concert with othermodifications that together selectively improve binding affinity to theP2X₇ receptor sites. These may include substitution of adenine forgroups such as formycin that are less likely to interact with otherproteins. Other modifications that may prove useful include extensionsto the polyphosphate tail preferably with non-hydrolyzable carbon ornitrogen insertions that collectively improve binding affinity. Thefinal analogue may then include combined modifications to the adeninegroup and polyphosphate tail and may include groups attached to theribose moiety. ATPase inhibitors such as Novartis ST1571 could be usedas templates for the design of specific inhibitors for the upregulatedATPases and ATPDases that may be removing available ATP for binding toP2X₇ receptors in cancer and other conditions.

The disease or condition is preferably malignant lymphoma or IBS but theinvention may also extend to other diseases or conditions, includingother epithelial cell or blood cancers or viral and other pathologicalinfections.

In the case of malignant lymphoma, the ATPases control the local supplyof ATP to the P2X₇ receptors so as to reduce the concentration of ATPavailable for binding to the P2X₇ receptors and so deactivate themleading to a significant reduction in programmed B-cell death. TheseATPases may be specifically expressed on the surface of the B-cells andappear to be up-regulated in malignant lymphoma. Preferably, applicationof a specific ATPase inhibitor may be used to regulate the availabilityof ATP on the P2X₇ receptors, so regulating programmed B-cell death.

For treatment of malignant lymphoma, the substance may include asynthetic agonist capable of blocking ATPases or ATPDases, of the formof non-hydrolysable P2X₇ agonist.

In relation to irritable bowel syndrome, administration of thepreparation of the invention is intended to restore receptor functionthat may be depleted through overactivity of the muscle underlying theaffected region of mucosa. The preparation of the invention may act onthe mucosa directly to remove these non-functional receptors and therebyrestore local normal gastrointestinal secretory mechanisms. Therapeutictreatment is aimed at restoring the local supply of ATP to thenon-functional receptors, so that normal receptor function is restored.The consequences of control of receptor function include restoration ofnormal control of gastrointestinal secretions and peristalsis. This maybe achieved by application of enteral or systemic supply of syntheticP2X₇-specific agonist, preferably non-hydrolysable by ATPases, bysystemic application of an antibody directed against non-functional P2X₇receptors, preferably a small human specific antibody to remove thenon-functional receptors, leaving only functional receptors.

If abnormalities of peristalsis in the underlying smooth muscle areresponsible for depleting the local availability of ATP for binding tothe normal P2X₇ receptors, treatment may involve restoration of thisnatural supply of agonist by means of a limit on the uptake or use ofATP by the smooth muscle through application of a treatment totemporarily limit gut motility.

The invention also provides a pharmaceutical composition for treatmentof a disease or condition, the composition including a pharmaceuticallyeffective amount of one or more substances adapted to regulate theexpression of ATPases (enzymes) that control the supply of ATP to P2X₇receptors.

The invention in all its aspects extends to such similar applicationsthat could be made in other medical conditions in which aberrant P2X₇receptors are involved as a result of viral infection where the virus isprotected in the infected cell by up-regulating non-functional P2X₇receptor or where such receptors are up-regulated from the normal cellcondition.

The invention also provides a method of treating irritable bowelsyndrome, comprising administering to a patient a pharmaceuticalcomposition as defined above.

The invention also provides the use of such a pharmaceutical compositionin the treatment of irritable bowel syndrome.

The pattern of use of one or more of the above pharmaceuticallyeffective agents may need to be altered for optimum effect.

Expressed another way, the invention provides a method of treatingirritable bowel syndrome, the method including administering acomposition adapted to restore P2X₇ receptor function. The receptorfunction may have been depleted through overactivity of the muscleunderlying the affected region of mucosa. The composition may be thesame as that set out above for the substance included in the preparationof the invention.

In a further aspect, the invention provides a method for distinguishingbetween different conformations of proteins by using an epitope capableof causing the generation of an antibody, or the antibody itself, toeffect specific pharmaceutical outcomes (active as well as passiveimmunisation) from binding to all members of the proteins with aselected conformation. An example of this would be prion proteins in theconformation that leads to the condition vCJD. The abnormal form of theprotein could be targeted by a specific antibody or epitope causing thegeneration of the antibody, preferably human and reduced in size foroptimum pharmacological effect.

DEFINITIONS

The following definitions illustrate conventional terminology in the artor conventional techniques in the art, and are provided for theconvenience of the reader.

The phrases “specifically binds” refers to a binding reaction which isdeterminative of the presence of the protein in the presence of aheterogeneous population of proteins and other biologics. Thus, underdesignated conditions, a specified ligand binds preferentially to aparticular protein and does not bind in a significant amount to otherproteins present in the sample. A molecule such as antibody thatspecifically binds to a protein often has an association constant of atleast 10⁶ M⁻¹ or 10⁷ M⁻¹, preferably 10⁸ M⁻¹ to 10⁹ M⁻¹, and morepreferably, about 10¹⁰ M⁻¹ to 10¹¹ M⁻¹ or higher. An antibody thatspecifically binds to one segment of a protein (e.g., residues 200-216)does not bind to other segments of the protein not included within oroverlapping the designated segment.

“Isolated” when referred to a molecule, refers to a molecule that hasbeen identified and separated and/or recovered from a component of itsnatural environment and thus is altered “by the hand of man” from itsnatural state. For example, an isolated peptide can be a component of alonger protein when linked to a heterologous peptide and still be“isolated” because the peptide is not in its original environment.Usually, when an isolated molecule occurs together with other componentas a mixture, the isolated molecule is the predominant component of themixture.

Allelic variants of a gene refer to variant forms of the same genebetween different individuals of the same species. Cognate forms of agene refers to variation between structurally and functionally relatedgenes between species. For example, the human gene showing the greatestsequence identity and closest functional relationship to a mouse gene isthe human cognate form of the mouse gene.

The term “epitope” refers to a site on an antigen to which B and/or Tcells respond.

Chimeric and humanized antibodies have the same or similar bindingspecificity and affinity as a mouse or other nonhuman antibody thatprovides the starting material for construction of a chimeric orhumanized antibody. Chimeric antibodies are antibodies whose light andheavy chain genes have been constructed, typically by geneticengineering, from immunoglobulin gene segments belonging to differentspecies. For example, the variable (V) segments of the genes from amouse monoclonal antibody may be joined to human constant (C) segments.A typical chimeric antibody is thus a hybrid protein consisting of the Vor antigen-binding domain from a mouse antibody and the C or effectordomain from a human antibody.

Humanized antibodies have variable region framework residuessubstantially from a human antibody (termed an acceptor antibody) andcomplementarity determining regions substantially from a mouse-antibody,(referred to as the donor immunoglobulin). See e.g., Queen et al., Proc.Natl. Acad. Sci. USA 86:10029-10033 (1989) and WO 90/07861, U.S. Pat.No. 5,693,762, U.S. Pat. No. 5,693,761, U.S. Pat. No. 5,585,089, U.S.Pat. No. 5,530,101 and Winter, U.S. Pat. No. 5,225,539 (incorporated byreference in their entirety for all purposes). The constant region(s),if present, are also substantially or entirely from a humanimmunoglobulin. The human variable domains are usually chosen from humanantibodies whose framework sequences exhibit a high degree of sequenceidentity with the murine variable region domains from which the CDRswere derived. The heavy and light chain variable region frameworkresidues can be derived from the same or different human antibodysequences. The human antibody sequences can be the sequences ofnaturally occurring human antibodies or can be consensus sequences ofseveral human antibodies. See Carter et al., WO 92/22653. Certain aminoacids from the human variable region framework residues are selected forsubstitution based on their possible influence on CDR conformationand/or binding to antigen. Investigation of such possible influences isby modeling, examination of the characteristics of the amino acids atparticular locations, or empirical observation of the effects ofsubstitution or mutagenesis of particular amino acids.

Human antibodies can be produced using the methods of Lonberg et al.,WO93/12227 (1993); U.S. Pat. No. 5,877,397, U.S. Pat. No. 5,874,299,U.S. Pat. No. 5,814,318, U.S. Pat. No. 5,789,650, U.S. Pat. No.5,770,429, U.S. Pat. No. 5,661,016, U.S. Pat. No. 5,633,425, U.S. Pat.No. 5,625,126, U.S. Pat. No. 5,569,825, U.S. Pat. No. 5,545,806, Nature148, 1547-1553 (1994), Nature Biotechnology 14, 826 (1996),Kucherlapati, WO 91/10741 (1991) or See, e.g., Dower et al., WO 91/17271and McCafferty et al., WO 92/01047, U.S. Pat. No. 5,877,218, U.S. Pat.No. 5,871,907, U.S. Pat. No. 5,858,657, U.S. Pat. No. 5,837,242, U.S.Pat. No. 5,733,743 and U.S. Pat. No. 5,565,332.

Unless otherwise apparent from the context, the term “antibody” or“immunoglobulin” is used to include intact antibodies and bindingfragments thereof. Typically, fragments compete with the intact antibodyfrom which they were derived for specific binding to an antigen fragmentincluding separate heavy chains, light chains Fab, Fab′ F(ab′)2, Fabc,and Fv.

DETAILED DESCRIPTION OF THE INVENTION

To raise the antibody specifically to non-functional P2X₇, the epitopeused was the sequence 200 to 216 in SEQ ID NO:1, containing a Cys at216.

To raise the antibody to non-discriminatory P2X₇, the epitope used wasthe sequence 65 to 81 in SEQ ID NO: 1, to which was added an N-terminalCys. This antibody could not detect whether the receptor wasnon-functional but was designed to detect all receptor so that theproportion of receptor that was functional could be determined bycomparing the staining obtained by using the two antibodies separately.

The Cys residues on the epitopes were coupled via amaleimidocaproyl-N-hydroxysuccinimide (MCS) cross linker to diphtheriatoxin (DT) carrier with ten peptide epitopes attached to each DTcarrier, to maintain conformational stability and provide a largerantigenic structure. These conjugated epitopes were used as the antigensfor injection into several animal species (sheep, rabbit and mouse) toraise antibodies specific to the epitopes, in the usual manner.

The procedure for raising antibodies is well documented in the prior artby use of antigen/adjuvant mixtures injected into animals at particulartimes. Specific examples for raising the antibodies are set out below:

EXAMPLE 1 Sheep Anti-P2X₇ Antibodies

500 μg of conjugate (approximately 100 μg of P2X₇ epitope) was dilutedin phosphate-buffered saline (PBS) to 0.8 mL and was emulsified with 1.2mL of Freund's Complete adjuvant. Sheep were injected at multiple sitesboth subcutaneously and intramuscularly with the antigen/adjuvantemulsion. Eight weeks later the sheep were again injected with the sameamount of conjugate emulsified with Freund's Incomplete adjuvant atmultiple sites. This was repeated 4 weeks later and the animals werebled from the jugular vein. The serum collected was tested for antibodyspecificity. The sheep were then routinely injected and bled at eightweek intervals to provide a pool of serum containing the specificantibodies.

Other sheep were injected with the same dose of conjugated antigensimilar to the schedule above but a different adjuvant was used. Inthese animals, 0.7 mL of the diluted antigen was mixed with 0.1 mL of aQuill A/DEAE Dextran solution (2.5 mg Quill A+25 mg DEAE Dextran per mLof PBS) and 1.2 mL of ISA 50V Montanide. The emulsion was injected atmultiple sites both subcutaneously and intramuscularly. The antibodiesproduced using this adjuvant produced the same specificities as thoseproduced using Freund's adjuvant.

EXAMPLE 2 Rabbit Anti-P2X₇ Antibodies

Antibodies were raised in rabbits using the same two adjuvants as withthe sheep and the same injection schedules, the only difference beingthat 300 μg amounts of the conjugate were used for the injection. Theantibodies raised had the same specificities as those produced in thesheep and could readily discriminate between the epitopes against whichthey were raised.

EXAMPLE 3 Mice Anti-P2X₇ Antibodies

Antibodies were raised in mice against the conjugated epitopes and alsoagainst the unconjugated epitope of the non-functional P2X₇ epitope(which is able to discriminate receptors that cannot from pores and thusfail to be apoptotic).

In these experiments, the adjuvant used was the QAIGEN™ Pty Ltd product,IMMUNEASY™ which contains the immuno-stimulatory product CpG DNA(trademark of Coley Pharmaceutical Group Inc.)

5 μg of epitope or conjugated epitope was diluted in 70 μL of PBS and 30μL of IMMUNEASY™ adjuvant. Mice were injected at multiple sitessubcutaneously and intramuscularly. This regime was repeated two weekslater and again at a further two weeks. Mice were bled eight days afterthe third injection. Antibodies raised in mice by this method were againable to discriminate between the different P2X₇ epitopes and theantibodies against the P2X₇ non-functional epitope gave the same resultsas those raised in sheep and rabbits.

As the above Examples illustrate, antibodies to various epitopes of theP2X₇ receptor in different species and using different adjuvants may beraised consistently. In particular, antibodies to an epitope of the P2X₇receptor which identifies the receptor in the non-functional state, inwhich it cannot form a pore and carry out its apoptotic function undernormal physiological conditions, may be raised routinely.

EXAMPLE 4

The antibody detecting non-functional P2X₇ was tested by binding theantibody to cells expressing P2X₇ (human) with known function asrevealed through the ability of the P2X₇ to take up ethidium orrubidium. These P2X₇ protein channels may have been mutated at base pair1513, such that the channels would not form apoptotic pores. These andsimilar non-functional P2X₇ receptors expressed on malignant Blymphocytes also bound the antibody in flow cytometry and in standardimmunohistochemistry while cells expressing normal functional P2X₇(capable of taking up calcium, ethidium and rubidium with large fluxes)were unable to bind the antibody, because the epitope chosen to detectthe non-functional receptors was unavailable in functional receptors.The Pro210 adopted a cis conformation in the non-functional receptorsand it was specifically this conformation that was stabilised in theconjugated epitope used to raise the antibody. The Pro210 was in thetrans conformation in the receptors that were shown to be functional.This was a result of the binding of ATP (adenosine triphosphate) to theP2X₇ receptor. When ATP was bound, the Pro210 on a segment immediatelyadjacent to the ATP binding site adopted a trans configuration.

This was verified using site directed mutagenesis to change the Pro2110to an Ala that was fixed in the trans configuration and this mutantprotein was found to be fully functional and unable to bind the antibodyraised to detect the non-functional receptor.

EXAMPLE 5

Further verification of the specificity of the antibody to detect thenon-functional receptor came in experiments that labelled macrophagesexpressing P2X₇. The macrophages bound antibody to the P2X₇ receptorsusing the P2X₇ universal antibody but did not bind the antibody tonon-functional P2X₇ until they had been exposed to cancer cells such asmouse hybridoma cells. Contact between the macrophages and the hybridomacells induced the expression on the macrophages of non-functional P2X₇that was detected by the antibody to non-functional P2X₇ as well as theuniversal P2X₇ antibody.

The macrophages and B-cell lymphocytes extracted from patients withmalignant lymphoma were tested and all these cells bound the antibody touniversal P2X₇ as well as the antibody to the non-functional P2X₇receptors, verifying that P2X₇ was non-functional in all the cancercells detected, with the apoptotic pore formed by functional P2X₇ unableto form and thus induce apoptosis in cancer cells.

All such cancer cells from all epithelial cell cancers in humans such asprostate, breast, bowel, skin, stomach, cervix and others as well asmalignant lymphoma, chronic lymphocytic leukaemia and brain tumours, aswell as the same tumours in other mammals that were tested, includingbreast and prostate in dog and skin in cat as well as all mousehybridoma cells and mouse fibrosarcoma cells, all express the samenon-functional P2X₇. Sequence similarity between human, rat, cat, dogand mouse at the chosen epitopes is sufficient for positiveidentification to be made in all the above cases. This shows that themechanism of cancer in these mammals is identical in that all cancercells express non-functional P2X₇ receptors unable to form apoptoticpores that would normally kill the cell when activated. In this way thecancer cells become immortal, with apoptosis being switched off.

EXAMPLE 6

As further verification that the cancer cells such as affected B-celllymphocytes are unable to induce apoptosis through P2X₇ function, Bcells from leukaemia patients containing non-functional P2X₇ receptorswere incubated with 5 mM ATP for 2 hours in culture. The results werethat all the non-functional receptors were forced by the excess ATP toopen and induce apoptosis that killed the affected cells.

EXAMPLE 7

As further verification that the antibody selectively binds cancercells, skin from patients with basal cell carcinomas (BCC) were treatedwith the antibody to the non-functional P2X₇ receptors, suspended in aninert cream base and applied to the lesion and surrounding skin (referExample 10, below). Within 1 week of daily application of the topicalantibody, all trace of the BCCs had disappeared with no effect onsurrounding skin since normal skin was devoid of the receptors.

Diagnostic Applications

Descriptions are provided here by way of example, using the specificnon-functional P2X₇ antibody in animals and demonstrating the universalapplication of the probe and method of the invention to the diagnosis ofmost cancers in humans and other mammals.

In prostate tissue from humans and mammals, such as cats and dogs, whenthe antibody of the invention is used for diagnosis, no labelling isobtained in the absence of cancer or pre-cancerous lesions. However, thediagnostic method of the invention reveals first signs of neoplasticchange while there is still no accompanying morphological changesdetectable by H&E stain.

At this stage, it is necessary to stain for the receptor units firstappearing in the nuclei of epithelial cells. These migrate to thecytoplasm in later stages of the disease, acting as a field effectthroughout the prostate, so that less tissue need be biopsied to becertain of the existence of a tumour. In later stages of the disease,the staining becomes more confined to the apical epithelium.

Similarly, other epithelial cell cancers, like breast, lung, colon andskin in humans and in other mammals, such as cats and dogs, can bedetected with margins as there is no longer a clear field effect inthese other tissues.

The same stage development is seen in these other tissues, like breastand cervix, with nuclear stain preceding cytoplasmic stain, while normaltissue is unstained. Affected ducts and lobules in breast tissue arereadily detected due to the local field effect within the individualaffected duct system in the breast even where normal morphology suggeststhere is no cancer. Adjacent unaffected ducts appear unstained.Similarly, affected lymph nodes, directly draining tissue containing atumour, show signs of the tumour through the field effect of affectedlymphocytes. Thus, sentinel nodes can be detected without there beingany metastatic cellular spread to the node.

Skin cancers, such as basal cell carcinoma, squamous cell carcinoma anddysplastic naevi as well as malignant melanomas show positive stainingfor non-functional receptors and channel components (monomers) inkeratinocyte and melanocyte layers with clear margins beyond whichnormal skin is unlabelled on both epidermis and deep within the dermis.

All tested mammalian cancer cell lines such as human prostate (PC3) andbreast (MCF7) and rodent hybridomas are positive for the non-functionalreceptors on the cell surface so that apoptosis is inhibited in thesecancer cells. The general application of this diagnostic is seen by wayof the same label on mouse hybridoma cells showing the ubiquitous natureof the receptor in other animal types besides human. Normal human B-celllymphocytes show that functional P2X₇ receptors are expressed on thecell surface, so enabling apoptosis when necessary, while human B-celllymphocytes from patients with malignant lymphoma show thatnon-functional P2X₇ receptors are expressed on the cell surface, socurtailing apoptosis.

Therapeutic Applications

Targeting this apparently ubiqitous P2X₇ non-functional conformerexpressed on the cell surface of cancer cells attempting to undergoapoptosis may be used to treat most cancers in humans and other mammals.Examples are set out below:

EXAMPLE 8

Mouse hybridoma cells were grown on a macrophage base both in thepresence and absence of affinity purified antibody to non-functionalP2X₇. Cell counts revealed that over 4 days while cells coincubated withpurified normal IgG grew from 1×10⁴ to 7×10⁴, coincubation withnon-functional P2X₇ antibody kept the cell count to only 1.5×10⁴.

EXAMPLE 9

This example shows that antibodies raised against the non-functionalepitope of the P2X₇ receptor can inhibit tumour formation in vivo.

As shown above, antibodies raised in sheep against the non-functionalP2X₇ epitope identified this non-functional P2X₇ apoptotic receptor onthe surface of mouse hybridoma cells. Addition of this antibody tohybridoma cell cultures retarded the growth of the cells. Mousehybridoma cells when injected into prepared inbreed mouse strains willcause tumour formation.

In this experiment, three groups of 10 Balb-c female mice each receivedthe following treatments:

Group 1: 10 mice each injected intraperitoneally (IP) with 1×10⁶hybridoma cells in 0.5 mL of cell culture medium on Day 1. On Days 2 and3, they received an intraperitoneal injection of 0.5 mL of cell culturemedium.

Group 2: 10 mice each injected intraperitoneally (IP) with 1×10⁶hybridoma cells in 0.5 mL of cell culture medium containing 1 mg ofpurified sheep IgG on Day 1. On Days 2 and 3, they were injected with0.5 mL of cell culture medium containing 1 mg of purified sheep IgG.

Group 3: 10 mice each injected intraperitoneally (IP) with 1×10⁶hybridoma cells in 0.5 mL of cell culture medium containing 1 mg ofpurified sheep anti-P2X₇ non-functional epitope IgG on Day 1. On Days 2and 3, they received a further injection of 0.5 ml of cell culturemedium containing 1 mg of purified sheep anti-P2X₇ IgG.

Mice from all the groups were killed on Day 11 and examined for thepresence of tumour. The tumours were excised and weighed.

The results were as follows:

Mean Tumour Weight per mice Groups Observations (±SD) (g) 1: Control 1 9out of 10 mice had rumours. 3.98 ± 1.1 2: Control 2 10 out of 10 micehad tumours  2.93 ± 0.9 3: Experimental 9 out of 10 mice had tumours1.13 ± 0.4

An analysis of variance showed a significant difference in tumour weightbetween the groups (probability P<0.01). The experimental group treatedwith the anti-P2X₇ non-functional antibodies was significantly different(P<0.01) from the two control groups. That is, treatment with antibodiesagainst the P2X₇ non-functional epitope significantly reduced the amountof tumour in the experimental animals.

EXAMPLE 10

Specific affinity purified antibody (to greatly improve specificity) wasapplied to 3 human basal cell carcinomas (“BCC”) either as a liquid heldin place for 7 days or suspended in a dimethicone cream base. No traceof the BCC lesions was detectable after treatment, while control skinwas entirely unaffected due to the absence of the protein target.

EXAMPLE 11

Skin lesions of the form of basal cell carcinoma (BCC) and squamous cellcarcinoma (SCC) (both primary tumours and secondary tumours), includingrelapsed tumours and dysplastic naevi, were treated in a further trialusing purified antibody, IgG either affinity purified or not, mixed indimethicone cream base or a penetrating cream base. Since there were nonon-functional receptors present in the normal skin there were no sideeffects detected in normal skin of any kind. The cancers of all typesall responded to the presence of the antibody by disappearing within aperiod from thirty six hours to one week with twice daily applications.No relapse has occurred in periods of up to twelve months. The size ofthe tumours treated ranged from 3 mm diameter with no raised border to 5cm diameter and up to 4 mm thick. A total of thirty four histologicallyconfirmed tumours have been successfully eliminated within one weektreatment periods.

It is believed that application to patients in general would involveproduction of a human monoclonal antibody (such as HERCEPTIN™) so thatinternal cancers could be treated with the same efficacy as is revealedwith topical application. All normal functional P2X₇ expressed on thecell surfaces of cells such as lymphocytes would need to remainunaffected by the presence of the antibody to avoid side effects. Theantibody should therefore only bind to proteins expressed on the cellsurface of cells attempting to but unable to initiate apoptosis. Thusall cells targeted would be only those attempting to kill themselvesthrough programmed cell death, including cancer cells. The P2X₇receptors on these cells, particularly cancer cells, would be in anon-functional or ATP-depleted state.

Active Immunisation

Active immunisation may also be used for therapeutic purposes. In thiscase the humans or other mammals need to be immunised against a specificepitope or epitopes that are in a conformation that mimics theconformation adopted only by the receptors in their non-functional(ATP-depleted) shape on the cell surface. Conformational flexibilitythat includes partial exposure of an epitope shape that is present infunctional receptors should be avoided. The cis configuration of theepitope Gly200-Cys216 as an example should be fixed before use byappropriate means. As added proof that this concept is sound is theobservation that numerous animals including mice, rabbits and sheep usedto raise the antibodies have not been immuno-compromised. None of thesemany animals have ever developed any tumours.

A specific example illustrates this:

EXAMPLE 12

Protocol: The experiment was conducted on the basis of a mouse tumourmodel. Forty ten-week old female inbred Balb C mice were used, anddivided into two groups of twenty, Group 1 being experimental and Group2 being the control group.

Day 1: The twenty experimental animals in Group 1 were injected with 0.1mg of the peptide epitope (hP2X₇ sequence 200-216) conjugated todiphtheria toxin via the MCS crosslinker. This contained approximately0.02 mg of the peptide epitope. The peptide conjugate was emulsifiedwith a QUILL A/DEAE Dextran/Montanide ISA 50V adjuvant mix and injectedin a volume of 0.1 mL at multiple subcutaneous and intramuscular sites.

The twenty mice in the control group, Group 2, were injected with 0.1 mLof the adjuvant mix without peptide conjugate at multiple subcutaneousand intramuscular sites.

Day 8: The twenty Group 1 mice were injected with 0.01 mg of the peptideepitope (hP2X₇ sequence 200-216) conjugated to diphtheria toxin via theMCS crosslinker (containing approximately 0.002 mg of the peptideepitope). The peptide was contained in a phosphate buffered salinesolution and mixed according to the protocol with the commerciallyavailable CpG DNA adjuvant ImmunEasy (from Qiagen). A volume of 0.1 mLof peptide conjugate/adjuvant solution was injected at multiplesubcutaneous and intramuscular sites in each mouse.

The twenty Group 2 mice were injected with the comparable phosphatebuffered saline/CpG DNA adjuvant mix. This was injected in a volume of0.1 mL in each mouse at multiple subcutaneous and intramuscular sites.

Day 26: The twenty Group 1 mice were injected with 0.025 mg of thepeptide epitope (hP2X₇ sequence 200-216) conjugated to diphtheria toxinvia the MCS crosslinker (containing approximately 0.005 mg of thepeptide epitope). This was contained in a phosphate buffered salinesolution and mixed with the Qiagen CpG DNA adjuvant ImmunEasy. Again 0.1mL of the mix was injected in each mouse at multiple subcutaneous andintramuscular sites. The control group was injected as before on Day 8.

Day 29: All mice received an injection of tumour cells at a singlesubcutaneous site located at the back of the neck in 0.1 mL of tissueculture media. The tumour cells used were a mouse fibrosarcoma cell linedeveloped by the Walter and Eliza Hall Institute in Melbourne Australiadesignated cell line WEHI 164.

The cells were injected at two concentrations into both the experimentaland control groups of mice. Each group was subdivided into two. Ten micefrom each of the experimental and control groups received 160,000 cellsper mouse and ten mice from each group received 320,000 cells per mouse.

The cells from this cell line had previously been tested for thepresence of the non-functional P2X₇ epitope on their cell surface. Thiswas done using an antibody raised in sheep which specifically recognisesthe non-functional form of the receptor.

Day 38: All mice were killed and blood collected for analysis ofantibodies to the non-functional P2X₇ epitope. All mice were weighed andthe tumours were excised and weighed.

Results

Control Experimental Control Experimental Group 160,000 cells 160,000cells 320,000 cells 320,000 cells n 10 10 10 10 Mean tumour 599 270 1147750 wt (mg) SD 307 108 633 363 SEM 97 34 200 115

Analysis of variance of the results showed a statistically significantdifference between control and treatment groups and between low and highdose groups (P=0.0003). The lower dose group showed a larger differencedue to the lower tumour load having less effect on the ability of themice immune systems to cope.

ATP Analogue

The efficacy of use of a synthetic agonist to effectively bind to ATPbinding sites on the P2X₇ pore, to force the pore to enter thefunctional state, thereby acting to restore receptor function as well ascontrolling the growth advantage that P2X₇ provides cells, is shown inthe following experiment in culture. Tumour B-cells collected from apatient with CLL, when mixed with a similar number of like cells from anormal patient were treated with ATP at 2.5 mM for four hours. No tumourcells remained, only normal cells. The use of ATP or the more selectiveP2X₇ agonist benzoyl, benzoyl ATP is not appropriate in vivo. Thus, aselective ATP analogue able to selectively bind to P2X₇ at much higheraffinity than either ATP or BzATP may be designed to reinstate theprocess of apoptosis in a range of affected tumour cell types.

INDUSTRIAL APPLICABILITY

The invention in all its aspects has application to the fields of humanand veterinary medicine and health, with the potential to enable earlyand accurate diagnosis of diseases and effective treatment, which inmany cases is far less invasive or traumatic than those available in theprior art.

Although the foregoing invention has been described in detail forpurposes of clarity of understanding, it will be obvious that certainmodifications may be practiced within the scope of the appended claims.All publications and patent documents cited herein are herebyincorporated by reference in their entirety for all purposes to the sameextent as if each were so individually denoted.

1. An antibody that binds to an extracellular domain of a P2X₇ receptor,said P2X₇ receptor having an amino acid sequence as shown in SEQ ID NO:1 in which the proline at position 210 is in a cis conformation, andwherein the antibody does not bind to an extracellular domain of a P2X₇receptor having an amino acid sequence as shown in SEQ ID NO: 1 in whichproline at position 210 is in a trans conformation.
 2. The antibody ofclaim 1, wherein the antibody binds to an epitope of the P2X₇ receptorcomprising Pro210 of SEQ ID NO:1.
 3. The antibody of claim 1, whereinthe antibody is selected from the group consisting of a polyclonalantibody, a monoclonal antibody, a recombinant antibody, a humanisedantibody, a human antibody and an antigen binding fragment of eachantibody type.
 4. The antibody of claim 1, wherein a radiolabel isattached to the antibody suitable for detection by use of scanningtechnology.
 5. The antibody of claim 4, wherein the scanning technologyis positron emission tomography.
 6. The antibody of claim 1, wherein afluorescent label is attached to the antibody suitable for use in flowcytometry.
 7. The antibody of claim 1, wherein a matrix is attached tothe antibody suitable for a calorimetric assay.
 8. A method fordetermining whether an epithelial cell or a blood cell is pre-neoplasticor neoplastic, wherein the method comprises: contacting an epithelialcell or a blood cell with the antibody of claim 1 under conditionssufficient for binding of the antibody to an extracellular domain of aP2X₇ receptor on the cell, said receptor having an amino acid sequenceas shown in SEQ ID NO: 1 in which proline at position 210 is in a cisconformation; and determining whether the antibody binds to the cell;wherein the binding of the antibody to the cell indicates that the cellis pre-neoplastic or neoplastic.
 9. The method of claim 8, wherein theepithelial cell is an epithelial cancer cell selected from the groupconsisting of prostate, breast, lung, cervix, uterus, stomach,oesophagus, bladder, colon, vaginal and skin cancer cells.
 10. Themethod of claim 9, wherein the skin cancer cell is selected from thegroup consisting of basal cell carcinoma (BCC), squamous cell carcinoma(SCC), malignant melanoma and dysplastic naevi.
 11. A method fortreating a cancer in a patient, wherein the method comprisesadministering to the patient a preparation comprising the antibody ofclaim
 1. 12. The method of claim 11, wherein the cancer is skin cancer.13. The method of claim 12 wherein the skin cancer cell is selected fromthe group consisting of basal cell carcinoma (BCC), squamous cellcarcinoma (SCC), malignant melanoma and dysplastic naevi.
 14. The methodof claim 12, wherein the antibody is topically administered.
 15. Anisolated polypeptide having a sequence shown in SEQ ID NO: 1 wherein theproline at position 210 is in a cis conformation.
 16. A polypeptidehaving the sequence shown in SEQ ID NO: 1, wherein the proline atposition 210 is in a cis conformation and wherein said polypeptide isbound by the antibody of claim 1.